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Free Content Differentiation of tuberculosis from lymphomas in neck lymph nodes with multidetector-row computed tomography

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BACKGROUND: Tuberculosis (TB) of the cervical lymph nodes may mimic lymphoma.

OBJECTIVE: To evaluate multidetector-row computed tomographic (MDCT) imaging criteria for differentiating between the two diseases.

MATERIALS AND METHODS: We retrospectively reviewed the anatomical distribution and CT enhancement patterns of the nodes in 81 patients, 27 (33%) with untreated TB and 54 (67%) with untreated lymphomas involving cervical lymph nodes. Of the patients with lymphomas, 19 (35%) had Hodgkin's disease and 35 (65%) had non-Hodgkin's lymphoma.

RESULTS: TB predominantly involved the upper cervical nodes. The supraclavicula fossa nodes on MDCT were involved more often in Hodgkin's disease (n = 15, 79%) and non-Hodgkin's lymphoma (n = 25, 71%) than in TB (n = 3, 11%). Tuberculous lymphadenopathy commonly showed peripheral enhancement, frequently with a multilocular appearance. Peripheral enhancement was significantly more frequent in TB (n = 19, 70%) than in Hodgkin's disease (n = 1, 5%) and non-Hodgkin's lymphoma (n = 1, 3%), but homogeneous enhancement was less common in the TB group.

CONCLUSION: Our findings indicate that a specific enhancement pattern of lymphadenopathy seen on MDCT was useful in differentiating between untreated TB and lymphomas of the cervical lymph nodes.
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Keywords: cervical lymph node; computed tomography; lymphoma; tuberculosis

Document Type: Research Article

Affiliations: Department of Radiology, West China Hospital, Sichuan University, Chengdu, China

Publication date: 2012-12-01

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  • The International Journal of Tuberculosis and Lung Disease publishes articles on all aspects of lung health, including public health-related issues such as training programmes, cost-benefit analysis, legislation, epidemiology, intervention studies and health systems research. The IJTLD is dedicated to the continuing education of physicians and health personnel and the dissemination of information on tuberculosis and lung health world-wide.

    Certain IJTLD articles are selected for translation into French, Spanish, Chinese or Russian. They are available on the Union website

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